The Prevalence and Factors Associated with Unsuppressed Viral Loads Among Adolescents Attending HIV Clinic in Kiryandongo Hospital, Kiryandongo District, Uganda

TABLE OF CONTENTS

DECLARATION .....................................................................................................................................i

APPROVAL..........................................................................................................................................ii

DEDICATION......................................................................................................................................iii

ACKNOWLEDGEMENT........................................................................................................................ iv

TABLE OF CONTENTS .......................................................................................................................... v

LIST OF FIGURES ............................................................................................................................... vii

DEFINITION OF TERMS..................................................................................................................... viii

LIST OF ABBREVIATIONS..................................................................................................................... ix

ABSTRACT.......................................................................................................................................... x

CHAPTER ONE .................................................................................................................................... 1

INTRODUCTION.................................................................................................................................. 1

1.0 Study Background ..................................................................................................................... 1

1.1 Theoretical Perspective ............................................................................................................. 2

1.2 Conceptual Perspective ............................................................................................................. 2

1.3 Contextual Perspective.............................................................................................................. 3

1.4 Problem Statement................................................................................................................... 3

1.5 General Objective...................................................................................................................... 3

1.5.1 Specific Objectives.................................................................................................................. 3

1.6 Research Questions................................................................................................................... 3

1.7 Significance of the Study............................................................................................................ 3

1.8 Conceptual Framework.............................................................................................................. 4

1.9 Scope of Study .......................................................................................................................... 4

CHAPTER TWO ................................................................................................................................... 6

LITERATURE REVIEW........................................................................................................................... 6

2.0 Introduction.............................................................................................................................. 6

2.1 HIV Virological Failure................................................................................................................ 6

2.1.1 Patient Adherence-Related Factors:.................................................................................. 6

2.1.2 HIV-Related Factors......................................................................................................... 6

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2.1.3 ARV Regime-Related Factors ........................................................................................... 7

2.2 Adherence to Anti- Retro Viral Drugs.......................................................................................... 7

2.2.1 Barriers to Nonadherence to ART..................................................................................... 7

2.2.2 Facilitators to Help Improve ARV Adherence................................................................... 8

2.3 Disclosure of HIV Status............................................................................................................. 9

2.3.1 Barriers to Disclosure of HIV Status................................................................................. 9

2.3.2 Facilitators to Disclosure of HIV Status .......................................................................... 10

2.4 Conclusions from Literature ..................................................................................................... 10

CHAPTER THREE ............................................................................................................................... 11

STUDY METHODOLOGY..................................................................................................................... 11

3.0 Introduction............................................................................................................................ 11

3.1 Research Design...................................................................................................................... 11

3.2 Study Area.............................................................................................................................. 11

3.3 Study Population..................................................................................................................... 11

3.4 Sample Size............................................................................................................................. 11

3.5 Sampling Method.................................................................................................................... 12

3.6 Data Collection........................................................................................................................ 12

3.7 Data Collection Procedures...................................................................................................... 12

3.8 Data Analysis and Presentation................................................................................................ 12

3.9 Ethical Considerations............................................................................................................. 12

3.10 Limitations of Study............................................................................................................... 12

CHAPTER FOUR................................................................................................................................. 13

RESULTS OF THE STUDY .................................................................................................................... 13

4.0 Introduction............................................................................................................................ 13

4.1 Socio-demographic Characteristics of Respondents................................................................... 13

4.2 Viral Load Suppression............................................................................................................. 14

4.3 Reasons for Failed Viral Load Suppression................................................................................. 16

CHAPTER FIVE .................................................................................................................................. 18

DISCUSSION OF RESULTS................................................................................................................... 18

5.0 Introduction............................................................................................................................ 18

5.1 Socio-demographic Characteristics........................................................................................... 18

5.2 Viral Load Suppression............................................................................................................. 18

5.3 Reasons for Failed Viral Load Suppression................................................................................. 19

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CHAPTER SIX .................................................................................................................................... 21

CONCLUSION AND RECOMMENDATIONS........................................................................................... 21

6.0 Introduction............................................................................................................................ 21

6.1 Conclusions............................................................................................................................. 21

6.2 Recommendations.................................................................................................................. 21

REFERENCES................................................................................................................................. 23

APPENDICES..................................................................................................................................... 25

Appendix I: Introductory Letter...................................................................................................... 25

Appendix II: Questionnaire ............................................................................................................ 26

Appendix III: Map of Uganda Showing the Location of Kiryandongo ................................................. 27

Appendix IV: Map of Kiryandongo and the Neighboring Regions..................................................... 28

Appendix V: Research Work Plan 2017/2018 .................................................................................. 29

Appendix VI: Research Budget....................................................................................................... 30